Provider Demographics
NPI:1568590719
Name:WEST FLORIDA MEDICAL SPECIALISTS PA
Entity Type:Organization
Organization Name:WEST FLORIDA MEDICAL SPECIALISTS PA
Other - Org Name:GASTROENTEROLOGY ASSOCIATES OF WEST FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:FREEDLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-846-7031
Mailing Address - Street 1:5622 MARINE PKWY STE 14
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-4330
Mailing Address - Country:US
Mailing Address - Phone:727-846-7031
Mailing Address - Fax:727-846-9444
Practice Address - Street 1:5622 MARINE PKWY
Practice Address - Street 2:SUITE 14
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4333
Practice Address - Country:US
Practice Address - Phone:727-846-7031
Practice Address - Fax:727-846-7132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2014-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000946500Medicaid
FL39190OtherBCBS
CN1580OtherRAILROAD MEDICARE
CN1580OtherRAILROAD MEDICARE